Patients with cancer-associated venous thromboembolism (VTE) represent a real challenge in clinical practice. Patients with cancer have a greater risk both of VTE and bleeding. There are only a few studies regarding the therapeutic approach of VTE in patients with cancer, especially after cancer surgery, and on thromboprophylaxis during chemotherapy. Many of the anticoagulation therapy recommendations for cancer patients are extrapolated from trials that are not conducted in cancer cohorts. It is essential to assess the efficacy and safety of VTE prophylaxis in this particular subgroup, which bears higher risks both of VTE recurrence and major hemorrhagic events. The introduction of direct oral anticoagulants in everyday practice represented a major evolution of the anticoagulant treatment. Direct anticoagulants could represent a more appealing alternative to low-molecular-weight heparin in paraneoplastic venous thrombosis, due to the patient comfort, easy administration of the drug and emerging studies that prove similar efficacy and safety as the standard treatment. However, there is limited data on the treatment with direct oral anticoagulants in patients with paraneoplastic venous thromboembolism.

Penile carcinoma is a relatively frequent health issue in the developing countries such as Africa, Asia and South America, usually affecting men aged between 50 and 70 years. It is a highly treatable disease in its early stages, but has serious physical and psychological consequences. Usually, penile carcinoma is located in the penile glans, in approximately half the cases, with the most frequent histological type being squamous cell carcinoma with its microscopic subtypes. A large number of risk factors have been reported for this disease, having a multifactorial etiology, HPV infection being one of the most important factors involved in its appearance. Out of the HPV DNA positive genital cancers HPV-16 is the most frequently found type in men, followed by HPV-18. The evolution of penile cancer includes two independent carcinogenic pathways, related or unrelated to HPV infection. There is limited data available in literature regarding HPV-related neoplasia, as well as on the efficacy of vaccination in men, with studies still ongoing.

Retroperitoneal space is called sometimes no man�s land�and for a good reason: this is disputed anatomical territory for many surgical and medical specialties. Their wide histological diversity and unspecific clinical presentation make them a challenge for the surgeon. In order to improve their detection immunohistochemistry seems to show promising results. Methods of detection have evolved over time to identify as much as possible the histological type of tumor. Because of this extreme variability immunohistochemistry through its various markers is the one that often sets the definitive diagnosis, the simple histopathological examination being insufficient. This paper aims to highlight the main markers used in retroperitoneal tumors. As it can be seen there is a huge histologic areal for these tumors. Some have proven some of them still not. Given the fact that there is a tendency toward personalized therapy it is imperative to identify the histological type of tumor as soon as possible.

Castleman�s disease (CD) is a rare and benign lymphoproliferative pathology, characterized by lymphoid tissue hyperplasia, process that can occur at any site of the lymphoid chain. The purpose of this paper is to review the existing data regarding Castleman�s disease etiopathogenesis and treatment. Considering the extent of the lymphoid tissue involvement Castleman�s disease can be classified as unicentric (UCD) and multicentric (MCD). Another classification of this pathology is based on the histopathological features: hyaline vascular CD (90% of cases), plasma cell CD (less than 10%) and mixed cell type. Patients with UCD have good prognosis, the gold standard treatment being complete surgical excision. The multicentric type in contrast to UCD has a worse prognosis and associates the risk of evolving to lymphoma. Over the years different therapeutic strategies have been applied in the management of multicentric Castleman�s disease: glucocorticoids, chemotherapy, antiviral agents and monoclonal antibodies that target CD (cluster of differentiation) 20, interleukin -6 (IL-6) and IL-6 receptors. Castleman�s disease is a rare and complex pathology, whose etiopathogenesis is still incompletely elucidated. In the past few years the overall survival and progression free survival has significantly increased, due to different therapeutic options that have emerged, options that have constantly offered better and better results. Further investigation regarding the chemical interactions between different receptors and therapeutic molecules, understanding the mechanism of action and the potential benefits of each therapeutic agent may prove useful in clinical practice for treating CD.

Pelvic organ prolapse is a frequent health problem in women, encountered worldwide, its physiopathology being still incompletely understood. The integrity of the pelvic-supportive structures is a key element that prevents the prolapse of the pelvic organs. Numerous researchers have underlined the role of connective tissue molecular changes in the pathogenesis of pelvic organ prolapse and have raised the attention upon oxidative stress as an important element involved in its appearance. The advancements made over the years in terms of molecular biology have allowed researchers to investigate how the constituent elements of the pelvic-supportive structures react in conditions of oxidative stress. The purpose of this paper is to underline the importance of oxidative stress in the pathogenesis of pelvic organ prolapse, as well as to highlight the main oxidative stress molecular changes that appear at the level of the pelvic-supportive structures. Sustained mechanical stress is proven to be a key factor in the appearance of pelvic organ prolapse, correlating with increased levels of free radicals production and mitochondrial-induced fibroblasts apoptosis, the rate of cellular apoptosis depending on the intensity of the mechanical stress, and the period of time the mechanical stress is applied. Oxidative stress hinders normal cellular signaling pathways, as well as different important cellular components like proteins, lipids, and cellular DNA, therefore significantly interfering with the process of collagen and elastin synthesis.